Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Elfi-Tech Ltd., Rehovot, Israel.
Sci Rep. 2022 May 6;12(1):7459. doi: 10.1038/s41598-022-10911-8.
Current haemodynamic monitoring is mainly aimed at the macrocirculation. Multiple studies have demonstrated the importance of the microcirculation in relation to the patient's condition and impact of treatment strategies. However, continuous monitoring of the microcirculation is not yet possible in the neonatal field. A novel dynamic light scattering (DLS) sensor technology for continuous monitoring of the microcirculation was investigated in the neonatal population. Thirty-one haemodynamically stable infants were included. Sequential measurements at the forehead, upper extremity, thorax, abdomen and lower extremity were conducted with the DLS sensor. For analyses stable measurements were selected. The DLS parameters, total blood flow (TBF) and relative blood velocity (RBV), were compared between measurement locations. Changes in relative haemodynamic indices (relHIs), indicating the distribution of blood flow in the microcirculatory blood vessels, were associated with heart rate decelerations. Measurements performed at the forehead had significantly lower TBF levels, compared to measurements at other locations. Early changes in relHIs around a heart rate deceleration were recorded a median (IQR) of 22.0 (13.5-27.0) s before the onset. Measurement of the currently unavailable parameters TBF, RBV and relHIs is possible with DLS technology. Validation of the DLS technology is needed for clinical implementation.
目前的血流动力学监测主要针对宏观循环。多项研究表明，微循环与患者的病情和治疗策略的影响有关。然而，新生儿领域还不能连续监测微循环。本研究旨在探讨一种新型动态光散射（DLS）传感器技术，用于连续监测新生儿的微循环。共纳入 31 例血流动力学稳定的婴儿。使用 DLS 传感器在前额、上肢、胸部、腹部和下肢进行连续测量。选择稳定的测量值进行分析。比较了 DLS 参数（总血流量[TBF]和相对血流速度[RBV]）在测量部位之间的差异。相对血液动力学指数（relHI）的变化表明微循环血管中血流的分布与心率减速有关。与其他部位相比，前额测量的 TBF 水平明显较低。在心率减速开始前中位数（IQR）22.0（13.5-27.0）s 即可记录到 relHI 的早期变化。DLS 技术可测量目前无法获得的 TBF、RBV 和 relHI 参数。需要对 DLS 技术进行验证，以将其应用于临床。
